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PHARM 2 > Gout > Flashcards

Gout Flashcards

1
Q

drugs that inc uric acid levels

A 
thiazide
loop
b blocker
niacin
low dose ASA
pyrazinamide
ethambutol
cyclosrone
tacrolimus
levodopa
ethanol
fructose
cytotoxic agents
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2
Q

acute tx gout (3)

A

dec inflammation:

NSAIDs
colchicine
glucocorticoids

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3
Q

first line for acute gout

A

NSAIDs

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4
Q

most popular for acute gout

A

indomethacin

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5
Q

what is contraindicated with indomethacin

A

ASA

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6
Q

cochicine AE

A

diarrhea - so bad that NSAIDs have replaced it
myopathy, neutropenia, aplastic anemia, alopecia

contraindicated in pregnancy, hepatic/renal/CV disease

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7
Q

chronic gout tx

A

lower urate concentration

1) decrease uric acid syntehsis
2) enhance uric acid excretion
3) enhance uric acid metabolism

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8
Q

allopurinol

A

decrease uric acid synthesis - inhib xanthine oxidase

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9
Q

febuxostat

A

decrease uric acid synthesis

same AE as allopurinol and drug interations with azathioprine and 6-mercaptopurine

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10
Q

probenecid

A

enhance uric acid excretion

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11
Q

pegloticase

A

enhance uric acid metabolism

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12
Q

first line for chronic gout

A

allopurinol

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13
Q

what drug can cause steven johnson syndrome

A

allopurinol

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14
Q

what happens if allopurinol is given alone

A

inc incidence of acute gout attacks

must give with NSAID or colchicine for the first few months

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15
Q

which gout tx can cause renal stones

A

probenecid

must drink lots of water, and keep urine alkaline (via sodium bicarb or K+citrate)

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16
Q

which pt should avoid probenecid

A

pt who overproduce uric acid or with nephrolithiasis

17
Q

what drug is simialr to losartan and fenofibrate?

A

probencid - all inhibit URAT1

18
Q

colchicine MOA

A

1) binds tubulin - inhibits polymerization = prevents microtubule formation - blocked cell division
2) disrupted motility of granulocytes to affected area
3) Inhibition of leukotriene synthesis/release

19
Q

allopurinol contraindications

A

mercaptopurine
azathioprine

= purine analogs metabolized by xanthine oxidase. if given with allopurinol = toxic levels of mercaptopurine and azathioprine accumulate

20
Q

probenecid MOA

A

URAT1 inhibitor = block uric acid reabsorption

21
Q

pegloticase MOA

A

recombinant form of uricase: oxidizes uric acid to allantoin (soluble and easily excreted from kidney)

22
Q

drug used in pt refractory to tx with xanthine oxidase inhibitors

A

pegloticase

PHARM 2 (18 decks)

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